Transverse connector

ABSTRACT

The present disclosure provides a transverse connector having first and second spinal rod connecting members disposed on opposing ends of a cross member. Each spinal rod connecting member is configured to connect to a spinal rod. The first and second spinal rod connecting members are configured for multidirectional articulation relative to the cross member.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a divisional of U.S. patent application Ser. No.13/251,546, filed Oct. 3, 2011, which is a continuation-in-part of Int'lApp. No. PCT/US2010/041693, filed on Jul. 12, 2010, which claims thebenefit of U.S. Provisional Patent Application No. 61/388,642, filedOct. 1, 2010, the entire contents of each of these prior applicationsare incorporated by reference.

TECHNICAL FIELD

The present disclosure relates to a transverse connector forinterconnecting a first and a second rod, which are in an approximatelyparallel relationship to each other. More particularly, the presentdisclosure relates to an offset transverse connector having opposingends and being capable of independent multidirectional articulationwhile preserving space for the anatomy.

BACKGROUND

Disease, the effects of aging, or physical trauma resulting in damage tothe spine has been treated in many instances by fixation orstabilization of the effected vertebra. A wide variety of spinalfixation apparatuses have been employed in surgical procedures forcorrecting spinal injuries and the effects of spinal diseases. Forexample, as illustrated in FIG. 16, many of these apparatuses commonlyuse a pair of longitudinal rods 50 running in a relatively parallelrelationship to each other and the spinal column S to correct any spinaldeformity involving a convexity or a concavity. These rods 50 areconnected to coupling elements, which in turn are secured to theunderlying vertebral bone V by spinal bone fixation fasteners such aspedicle screws, hooks, and the like. More particularly, depending uponthe nature of the deformity, suitable bone screws 48 may be firstimplanted into the vertebral bone V of the spinal column S at multiplepoints above and below the apex A of the curve. Rod reduction devices 10including manipulation devices 28 adapted and configured for attachmentto heads of the bone screws 48, and which provide leverage to facilitatethe manipulation of the spinal column S, can then be attached to theheads of the bone screws 48. With continuing reference to FIG. 16, therod reduction device 10 is attached to the heads of the bone screws 48on the concave side S1 of the spinal deformity. The manipulator device28 is placed on the bone screws 48 on the convex side S2 of the spinaldeformity. Depending upon the nature of the deformity, the rod reductiondevice 10 can be used on both sides of the deformity.

Prior to any correction of the rods 50, the surgeon can manipulate andcorrect the curve of the spinal column S to a large degree. That is, thesurgeon can first manually manipulate and reduce the “rib hump.” Thespinal rod 50 can be pre-bent to the configuration of the normal spinalcurve, e.g., the sagittal curve. Once certain the spine S is in theproper anatomical position, the surgeon can position the pre-bent spinalrods 50 relative to the screws 48 and the rod reduction devices 10, andlock each rod 50 to the first two points of the spinal column where theconstruct is to be attached for enabling the correction of thedeformity. In order to facilitate the desired positioning of the pair oflongitudinal rods 50 relative to the spinal column S, the pair oflongitudinal rods 50 can be held in position relative to one another bytransverse connectors, also known as transverse bridge elements orcross-connectors.

As the technology of spinal surgery has developed and improved, each ofthe spinal fixation components has also undergone improvements andmodifications to address the shortcomings of conventional spinalappliances. The natural anatomical variations in the spinal column of asubject are such that implanted spinal rods while approximating aparallel relationship one to the other can vary from that parallelrelationship considerably and in multiple planes. For this reason, anytransverse connector used to attach the two rods to each other shouldnot be of a rigid design without the ability to be re-configured asneeded during the process of implanting and attaching to the twoopposing rods. While some improvements have been made in thearticulation and re-configuration operation of transverse connectorsduring the implantation and rod connecting process, a continuing needexists to provide a multidirectional articulating transverse connectorthat can adapt to a wide variance in the contours of the spinal column.Further, a need exists to provide such a transverse connector that canprovide sufficient space for the underlying anatomy, most specifically,the dura and spinal cord, while still maintaining a low profile and asmooth contoured surface to thereby reduce the potentially negativeimpact of the implanted device on the underlying and surrounding softtissue of the subject into which the device has been surgicallyimplanted.

Conventional efforts to meet this need have fallen short of the desiredtransverse connector configuration. For example, U.S. Pat. No.6,554,832, issued to Shluzas, as best seen in FIGS. 2 and 4 of thatpatent, provides a transverse connector, which includes first and secondconnector members for connecting to the respective first and secondspinal rods. The two connector members are connected one to the other bya connecting rod, which can be withdrawn or extended in alignment withthe longitudinal axis of the cross-connector for purpose of adjustingthe length thereof. As shown in FIGS. 2 and 4 of the Shluzas patent, thearticulation of the connecting members to align with the two opposingspinal rods is limited to a single, centrally disposed ball joint (50).Importantly, the pivoting movement of the Shluzas connector is limitedto movement within the same horizontal plane relative to thelongitudinal axis of the spinal column. Thus, while the device ofShluzas does permit some limited adjustment in length and azimuth of thedevice, it is configured to structurally prohibit any upward or downwardmovement in relation to the surface plane of the spinal column. That is,the elevation of one end of the Shluzas connector relative to the otherend of the connector cannot be adjusted. Thus, while the Shluzas designdoes provide some flexibility in adapting the alignment of thetransverse connector to the opposing spinal rods, it falls short of thegreater degree of adaptability that could be obtained by a trulymulti-planar transverse connector having multiple articulating points.In U.S. Pat. No. 6,110,173, issued to Thomas, more specifically FIGS. 1and 3, show the rigid nature of the cross connecting rod which does notallow for sufficient space for spinal anatomy. In this regard, thecurrent device affords an improvement in this area as well since thecross-connecting member is arched to allow for such anatomy.

For reasons discussed above a continuing need exists for a transverseconnector that provides ease of operation by the surgeon tosimultaneously adjust in multiple dimensions one spinal rod connectingend of the connector in relation to the other spinal rod connecting endof the connector and to provide a transverse connector having means forproviding sufficient space for spinal anatomy and smooth contours forsurfaces in contact with adjacent soft tissue.

SUMMARY

The present disclosure is directed to a transverse connector systemincluding a first spinal rod, a second spinal rod, and a transverseconnector. The transverse connector includes a cross member, a firstspinal rod connecting member, and a second spinal rod connecting member.The cross member includes opposing first and second ends as well asfirst and second ball joints disposed at the respective first and secondends. The first and second spinal rod connecting members are secured tothe first and second ball joints of the cross member. One or both of thefirst and second spinal rod connecting members may be configured toarticulate in multiple directions about one of the first and second balljoints of the cross member.

Each of the first and second spinal rod connecting members has acompression region. The compression region is configured to selectivelyand releasably secure to one of the first and second spinal rods. One ormore compression slots cooperate with a corresponding ball jointreceptacle to define a first compression region.

Each spinal rod connecting member is adapted to receive a locking screw.Each locking screw is operatively coupled to its respective ball jointsuch that rotation of the locking screw retains the respective spinalrod connecting member in a fixed relationship with the cross member.Rotation of the locking screw fixes the relationship between therespective spinal rod connecting member and the cross member and securesthe spinal rod to the respective spinal rod connecting member.Tightening of the locking screw may lock both the spinal rod and therespective ball joint.

Each of the spinal rod connecting members may include first and secondcompression slots. Each of the first and second compression slots may bedimensioned to pass, one over the other, through a portion of the spinalrod connecting members. The compression slots may have opposing sides oforigin and opposing directions of penetration into the spinal rodconnecting members. Rotation of the locking screw approximates theopposing sides of origin thereby retaining each of the first and secondspinal rod connecting members in the fixed relationship with the crossmember.

The first and second spinal rod connecting members each include a spinalrod connecting passage defined between first and second spinal rodretention lips. Each of the first and second spinal rod retention lipsproject toward one another to an opening to facilitate retention of thespinal rod. One or more of the compression slots originate adjacent tothe spinal rod connecting passage such that the one or more compressionslots, the first spinal rod retention lip, and the second spinal rodretention lip define a second compression region.

The first and second spinal rod connecting members each define a balljoint receptacle. Each ball joint receptacle may have a lateral openingconfigured to receive one of the first and second ball joints of thecross member.

The length of the cross member may be selectively adjustable. The crossmember may include a curved configuration. The cross member may includean offset cross member providing an offset configuration such that firstand second spinal rod connecting members are disposed in a first planeand at least a portion of the offset cross member is disposed in asecond plane that is spaced apart and parallel to the first plane.

First and second cross member connecting elements may be secured to thecross member. Each of the first and second cross member connectingelements includes a cross member clamp portion and a linking arm. Thelinking arm has an articulating ball joint. The first and second crossmember connecting elements may include a cross member receptacle that isdimensioned and configured to receive an end of the cross member. Thecross member clamp portion of each cross member connecting elementincludes a top portion, a bottom portion, and a cross member lockingscrew receptacle that is defined orthogonally through the top and bottomportions. The top and bottom portions are separated by a compressionslot defined therebetween. Rotation of the cross member locking screw ina first direction allows one or both of the spinal rod connectingmembers to move relative to the cross member. Rotation of the crossmember locking screw in a second direction fixes one or both of thespinal rod connecting members relative to the cross member.

The cross member may include an insertion arm and a receiving arm. Thereceiving arm defines a space therein and is configured to receive theinsertion arm to thereby adjust the length of the cross member element.One or both of the insertion arm and the receiving arm have a crossmember locking screw receptacle configured to receive a cross memberlocking screw such that rotation of the cross member locking screwexerts pressure against one or both of the insertion arm and thereceiving arm to thereby maintain the insertion arm and the receivingarm in a fixed position.

One or both of the first and second ball joints define a recess therein.One or more of the locking screws includes a post extending therefrom.The post is engagable with the recess to retain the respective spinalrod connecting member in a fixed relationship with the cross member andto secure the spinal rod within the compression region. The post and asurface of the recess define a space therebetween when the post and therecess are fully engaged to allow one of the first and second spinal rodconnecting members to move slightly relative to one or both of the firstand second ball joints through the space such that the respective spinalrod connecting member is in a fixed relationship with the cross memberexcept for the slight movement through the space.

One or both of the spinal rod connecting members defines a receptacle.At least a portion of one of the respective ball joints, an insert, andone of the respective locking screws are positionable within thereceptacle to retain the respective spinal rod connecting member in afixed relationship with the cross member and to secure the spinal rodwithin the compression region. The respective ball joint defines arecess and the insert includes a post extending therefrom. The post isengageable with the recess when the screw is rotated in a firstdirection within the receptacle. The engagement of the post and therecess facilitates the retention of the respective spinal rod connectingmember in a fixed relationship with the cross member and the securementof the spinal rod within the compression region.

According to one aspect, the present disclosure is directed to a methodfor securing a transverse connector to a pair of spinal rods. The methodincludes the step of providing a transverse connector including a crossmember, a pair of spinal rod connecting members, and at least onelocking screw. The method involves connecting a spinal rod to eachspinal rod connecting member, multi-directionally articulating one orboth of the spinal rod connecting members relative to the cross member,and rotating the one or more locking screws relative to one of the pairof spinal rod connecting members to fixedly secure one of the spinalrods to the one of the pair of spinal rod connecting members and to fixthe one of the pair of spinal rod connecting members in a positionrelative to the cross member. One step involves adjusting the length ofthe cross member. The method may include fixing the length of the crossmember via a locking screw rotatably secured to the cross member. Themethod may involve compressing one or both of the spinal rod connectingmembers by rotating the one or more locking screws relative to one orboth of the spinal rod connecting member such that dimensions ofcompression slots defined within one or both of the spinal rodconnecting members are reduced, thereby facilitating the securement ofone of the spinal rods within one or both of the spinal rod connectingmembers.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other features of the offset transverse connector willbecome apparent to one skilled in the art to which the disclosedtransverse connectors relate upon consideration of the followingdescription of exemplary embodiments with reference to the accompanyingdrawings, wherein:

FIG. 1A is a perspective view of an offset transverse connector, inaccordance with an embodiment of the present disclosure;

FIG. 1B is an end view of the offset transverse connector of FIG. 1A;

FIG. 1C is a top view of the offset transverse connector of FIG. 1A;

FIG. 1D is a cross-sectional view taken along line A-A in FIG. 1C;

FIG. 2A is a top view of a spinal rod connecting member of the offsettransverse connector of FIG. 1A;

FIG. 2B is a side cross-sectional view taken along line B-B in FIG. 2A;

FIG. 3A is a top view of a locking screw of the offset transverseconnector of FIG. 1A;

FIG. 3B is a side cross-sectional view taken along line C-C in FIG. 3A;

FIG. 4A is a perspective view of another embodiment of an offsettransverse connector, in accordance with the present disclosure;

FIG. 4B is an end view of the offset transverse connector of FIG. 4A;

FIG. 4C is a top view of the offset transverse connector of FIG. 4A;

FIG. 4D is an exploded view, with parts separated, of the offsettransverse connector of FIG. 4A;

FIG. 5 is a side view of a cross member connecting element of the offsettransverse connector of FIG. 4A;

FIG. 6A is a perspective view of yet another embodiment of an offsettransverse connector, in accordance with the present disclosure;

FIG. 6B is a top view of the offset transverse connector of FIG. 6A;

FIG. 6C is a side cross-sectional view taken along line A-A in FIG. 6B;

FIG. 6D is an end view of the offset transverse connector of FIG. 6A;

FIG. 6E is an exploded view, with parts separated, of the offsettransverse connector of FIG. 6A;

FIG. 7A is a perspective view of a spinal rod connecting member of theoffset transverse connector of FIG. 6A;

FIG. 7B is an end view of the spinal rod connecting member of FIG. 7A;

FIG. 7C is a top view of the spinal rod connecting member of FIG. 7A;

FIG. 7D is a side cross-sectional view taken along line B-B in FIG. 7C;

FIG. 8A is a perspective view of a locking screw of the offsettransverse connector of FIG. 6A;

FIG. 8B is a top view of the locking screw of FIG. 8A;

FIG. 8C is a side cross-sectional view taken along line C-C in FIG. 8B;

FIG. 9A is a perspective view of a cross-member of the offset transverseconnector of FIG. 6A;

FIG. 9B is a side view of the cross member of FIG. 9A;

FIG. 10A is a perspective view of an insert of the offset transverseconnector of FIG. 6A;

FIG. 10B is a side view of the insert of FIG. 9A;

FIG. 11A is a perspective view of another embodiment of an offsettransverse connector, in accordance with the present disclosure;

FIG. 11B is an end view of the offset transverse connector of FIG. 11A;

FIG. 11C is a top view of the offset transverse connector of FIG. 11A;

FIG. 11D is a side cross-sectional view taken along line A-A in FIG.11C;

FIG. 12A is a perspective view of yet another embodiment of an offsettransverse connector, in accordance with the present disclosure;

FIG. 12B is an end view of the offset transverse connector of FIG. 12A;

FIG. 12C is a top view of the offset transverse connector of FIG. 12A;and

FIG. 12D is a side cross-sectional view taken along line A-A in FIG.12C;

FIG. 13A is a perspective view of another embodiment of a transverseconnector in accordance with the present disclosure;

FIG. 13B is a top view of the transverse connector of FIG. 13A;

FIG. 13C is a side view of the transverse connector of FIG. 13A;

FIG. 13D is a side cross-sectional view of the transverse connector ofFIG. 13A;

FIG. 14A is a perspective view of yet another embodiment of a transverseconnector in accordance with the present disclosure;

FIG. 14B is a side cross-sectional view of the transverse connector ofFIG. 14A;

FIG. 15A is a perspective view of yet another embodiment of a transverseconnector in accordance with the present disclosure;

FIG. 15B is a side cross-sectional view of the transverse connector ofFIG. 15A; and

FIG. 16 shows a dorsal view of a section of a spinal column with aplurality of bone screws attached to spinal vertebrae of the spinalcolumn, two spinal rods engaged with the plurality of bone screws, aplurality of rod reduction devices attached to the bone screws, and aplurality of manipulators attached to the bone screws.

DETAILED DESCRIPTION

Detailed embodiments of the present disclosure are disclosed herein,however, it is understood that the following description and each of theaccompanying figures are provided as being exemplary of the disclosure,which may be embodied in various forms without departing from the scopeof the present disclosure. Thus, the specific structural and functionaldetails provided in the following description are nonlimiting, but servemerely as a basis for the disclosure as defined by the claims providedherewith.

FIGS. 1A-3B illustrate a transverse connector shown generally as 10.Transverse connector 10 includes first and second spinal rod connectingmembers 12 a and 12 b. The spinal rod connecting members 12 a and 12 bare coupled by a cross member 60.

The two spinal rod connecting members 12 a and 12 b are each configuredto be selectively and releasably secured to a spinal rod 90 (as shown inFIG. 1B), which in turn can be secured to the underlying bone of apatient's spinal column as needed. As shown in FIGS. 1A-1D, the spinalrod connecting members 12 a and 12 b are each configured at theiroutermost ends 14 a and 14 b, respectively, of the transverse connector10 to define first and second spinal rod connecting passages 16 a and 16b, the spinal rod connecting passages 16 a and 16 b being openedmedial-laterally at respective first and second ends 14 a and 14 b ofthe transverse connector 10. The outermost edges of the respectivemedial-laterally opened spinal rod connecting passages 14 a and 14 b maybe configured to provide upper spinal rod retention lips 18 a and 18 band lower spinal rod retention lips 20 a and 20 b, each of whichprojects one toward the other so as to narrow the lateral opening of thespinal rod connecting passages 16 a and 16 b and to thus facilitate thespinal rod retention capability of the two spinal rod connectingpassages 16 a and 16 b.

The first and second spinal rod connecting members 12 a and 12 b areeach sized and configured at their innermost ends 22 a and 22 b todefine a ball joint receptacle 24, each ball joint receptacles 24 has alateral opening sized and configured to receive a correspondingly sizedball joint 68 and 72 of cross member 60 in a snap-fit manner.

Referring now to FIG. 1B-1D, the cross member 60 includes a cross memberelement 62 having a U-shaped configuration. Cross member element 62includes a mid-portion 64, a first end 66 and a second end 70. First end66 may be configured to provide articulating ball joint 68 and secondend 70 may be configured to provide articulating ball joint 72. Crossmember element 62 further includes an inner periphery 74 that defines aninner cavity 76 to provide space between first and second spinal rodconnecting members 12 a and 12 b. In addition, cross member 60 providesan offset configuration such that first and second spinal rod connectingmembers 12 a and 12 b oppose each other and define a space 78therebetween, as shown in FIG. 1C.

The features and operation of spinal rod connecting member 12 b aresubstantially identical to spinal rod connecting member 12 a and will beomitted in the interest of brevity. Referring now to FIGS. 2A and 2B,spinal rod connecting member 12 a includes an upper surface 26 a anddefines a spinal rod locking screw receptacle 28, which is sized andconfigured to receive a spinal rod locking screw 80 (as shown in FIGS.3A and 3B). The spinal rod locking screw receptacle 28, as best shown inFIG. 2B is provided with threads only in a lower portion 30 ofreceptacle 28. In addition, lower portion 30 of receptacle 28 isprovided below the elevation of the spinal rod connecting passages 16 aand 16 b. An upper portion 32 of spinal rod locking screw receptacle 28is provided located above the level of the spinal rod connectingpassages 16 a and 16 b and is unthreaded. Upper portion 32 includes aninwardly directed annular restricting ledge 34 that is dimensioned andconfigured to abut an outwardly directed flange 84 of spinal rod lockingscrew 80, which will be described further below.

Referring now to FIGS. 3A and 3B, locking screw 80 includes a threadedportion 82 and outwardly directed flange 84 that is provided below aspinal rod locking screw head 86. During use, locking screw 80 isinserted within receptacle 28 of both spinal rod connecting members 12 aand 12 b (as shown in FIG. 1D), which permits threaded portion 82 oflocking screw 80 to pass freely therethrough until threaded portion 82engages lower threaded portion 30 of the spinal rod locking screwreceptacle 28 of both first and second spinal rod connecting members 12a and 12 b. In this configuration, as threaded portion 82 of lockingscrew 80 (as shown in FIG. 1D) is threaded further into threaded portion30 of receptacle 28, outwardly directed flange 84 on the underside ofthe spinal rod locking screw head 86 is brought into contact with theinwardly directed annular restricting ledge 34 of the upper portion 32of receptacle 28.

Spinal rod locking screw 80 further includes a tool cavity 88 so that aclinician may manually screw locking screw 80 with a suitable tool (notshown), for example, but not limited to a screwdriver or a TORX® wrench.As screw 80 is screwed into the threaded portion 30 of the spinal rodlocking screw receptacle 28, flange 84 on the underside of screw head 86exerts compressive forces against the inwardly directed annularrestricting ledge 34, as will be described further below.

As shown in FIGS. 1A and 2B, each of spinal rod connecting members 12 aand 12 b is configured to define first and second compression slots 38and 39, which from opposing directions in the body of the spinal rodconnecting members 12 a and 12 b can break the external integrity of themembers 12 a and 12 b through the defining wall of the spinal rodconnecting passage 28 and the ball joint receptacle 24 of members 12 aand 12 b. Each compression slot 38, 39 is defined to pass, one over theother, through only a limited portion of the body of the spinal rodconnecting members 12 a and 12 b. By configuring the pair of overlyingcompression slots 38 and 39 to have opposing sides of origin and, thus,opposing directions of penetration into the body of the spinal rodconnecting members 12 a and 12 b, a connecting member is provided thatcan react to the above described compressive forces of an inwardlymanipulated spinal rod locking screw 80 so as to bring those compressiveforces to bear on both the spinal rod connecting passage 28 and the balljoint receptacle 24, which fixes the relationship between spinal rodconnecting members 12 a and 12 b and locks cross member 60 in place.That is, when each locking screw 80 of spinal rod connecting members 12a and 12 b is tightened, spinal rod 90 and cross member 60 are locked ina desired position. Thus, by tightening and loosening each locking screw80 of spinal rod connecting members 12 a and 12 b, the configuration oftransverse connector 10 may be changed. In addition, the compressionslots 38, 39 cooperate with the ball joint receptacle 24 to define afirst compression region. Further still, the compression slots 38, 39cooperate with the upper and lower spinal rod retention lips 18, 20 andthe spinal rod connecting passage 16 to define a second compressionregion.

As discussed above and as shown in FIGS. 1A-1D, opposing spinal rodconnecting members 12 a and 12 b are connected to each other by crossmember 60. In embodiments, cross member 60 is arched to providesufficient space for spinal anatomy and therefore not impinge onsurrounding tissue or spinal elements.

As shown in the non-limiting examples of FIGS. 1-4, any articulatingsurface of the transverse connector can be treated, machined, scored, orin any known manner textured to provide a roughened or textured surfacethat can serve to increase the locking contact of those surfaces whenthe articulating members are set in place and the associated lockingscrews are manipulated to lock the transverse connector in the desiredconfiguration.

In operation, a user, as indicated above, can manipulate the transverseconnector 10 into a position relative to two opposing and relativelyparallel spinal rods, independently connecting the first and secondspinal rod connecting members 12 a and 12 b to their respective spinalrods and adjusting the alignment of the spinal rod connecting members 12a and 12 b with the centrally connected cross member 20 by manipulatingthe respective first ball joint 68 within the ball joint receptacle 24of spinal rod connecting member 12 a and the second ball joint 72 withball joint receptacle 24 of spinal rod connecting member 12 b andselecting the appropriate length of the cross member 60. When allmembers of the transverse connector 10 are properly positioned, the usercan tighten the provided locking screws 80, and lock the transverseconnector into a selected configuration relative to the two opposingspinal rods. Adjustment or removal of the transverse connector can beeasily achieved by loosening the locking screws 80.

As discussed above, first spinal rod connecting member 12 a and secondspinal rod connecting member 12 b are connected to each other by crossmember 60 which terminates at each end 66 and 70 with a respectivearticulating ball joint 68 and 72. Articulating ball joints 68 and 72allow cross member 60 to rotatably connect to and articulate with spinalrod connecting members 12 a and 12 b, as described above. In thisembodiment, transverse connector 10 simplifies the insertion andadjustment thereof and provides a fixed length between spinal rodsduring a surgical procedure.

The above described method of use of the transverse connector 10 can beemployed with the use of a plurality of spinal rods 90 and associatedbone connecting devices as a method of stabilizing or fixing injured ordiseased vertebrae and if necessary, multiple transverse connectors 10can be employed along the length of the opposing spinal rods 90.

FIG. 4A-4D illustrates another embodiment of the presently disclosedtransverse connector shown generally as 100. Transverse connector 100 issimilar to other embodiments described herein and therefore is onlydescribed herein to the extent necessary to describe the differences inconstruction and operation thereof. Transverse connector 100 generallyincludes first and second spinal rod connecting members 12 a and 12 bfor connection to one or more spinal rods 90 (as shown in FIG. 4B).First and second spinal rod connecting members 12 a and 12 b oftransverse connector 100 is substantially similar to the first andsecond spinal rod connecting members 12 a and 12 b used with transverseconnector 10 and further description thereof will be omitted in theinterest of brevity. Transverse connector 100 further includes crossmember connecting elements 130 a and 130 b that are coupled by a crossmember element 120, which may be, for example but not limited to a rod.In this embodiment, cross member element 120 allows for adjustment tothe length of the transverse connector 100 to custom fit the patient'sanatomy. That is, the distance between the cross member connectingelements 130 a and 130 b may be adjusted to a particular surgicalprocedure. In still another embodiment, not shown, cross member element120 may be contoured or bent in order to avoid interference withexisting anatomy or aid in the fixation of the transverse connector.

Referring now to FIG. 5 in conjunction with FIGS. 4A-4D, first andsecond cross member connecting elements 130 a and 130 b are provided andinclude a cross member clamp portion 132, a linking arm 134 coupled toan articulating ball joint 136. Articulating ball joint 136 is connectedto linking arm 134 by a connecting member 138. Ball connecting member138 may have a conical tapered configuration. For example, ballconnecting member 138 may taper from a large radius to a smaller radiusfrom linking arm 134 to articulating ball joint 136. First and secondcross member connecting elements 130 a and 130 b further include a crossmember receptacle 140 that is dimensioned and configured to receive afirst end 120 a or a second end 120 b of cross member element.

Cross member clamp portion 132 of each cross member connecting element130 a, 130 b includes a top portion 142, a bottom portion 144 and across member locking screw receptacle 148 that is defined orthogonallythrough top portion 142 and bottom portion 144. Top portion 142 andbottom portion 144 are separated by a compression slot 146 that isdefined therebetween.

As shown in FIG. 4D, cross member locking screws 180 are similar tolocking screws 80, however, locking screws 180 may be shorter in lengthso as to fit within screw receptacle 148 of clamp portion 132 of eachcross member connecting element 130 a, 130 b. Locking screw 180 includesa threaded portion 182, an outwardly facing flange portion 184 and atool cavity 186 for removal of the screw thereof. Upon insertion of thecross member locking screw 180 within cross member locking screwreceptacle 148, compression slot 146 is compressed such that topportions and portions 142 and 144 are approximated towards each other.In this manner, an inner dimension of cross member receptacle 148decreases in size, for example, its diameter, to thereby retain crossmember 120 in a compressed configuration.

Referring now to FIGS. 6A-6F, another embodiment of a transverseconnector is shown and generally depicted as 200. Transverse connector200 is similar to other embodiments described herein and therefore isonly described herein to the extent necessary to describe thedifferences in construction and operation thereof. Transverse connector200 includes an arcing cross member 220, spinal rod connecting members230, and a cross member locking screw 280. In embodiments, cross member220 is arched to provide sufficient space for spinal anatomy andtherefore not impinge on surrounding tissue or spinal elements.

Referring to FIGS. 9A and 9B, arcing cross member 220 includes a balljoint 226 on each end 222, respectively, that is connected by a ballconnecting member 224. Ball connecting member 224 may have a conicaltapered configuration. For example, ball connecting member 224 may taperfrom a larger radius to a smaller radius from end 222 to ball joint 226.Each ball joint 226 includes a recess 228 that will be described furtherbelow.

Referring now to FIGS. 7A-7D in conjunction with FIGS. 6A-6D, a spinalrod connecting member 230 is shown including a body 232 having a topportion 232 a and a bottom portion 232 b. Top portion 232 a defines across member locking screw receptacle 234 and bottom portion 232 bdefines a spinal rod passage 236 adapted to receive and contain a spinalrod 90 (as shown in FIG. 6D). Cross member locking screw receptacle 234includes threads 238 along its periphery, an inner cavity 240, a balljoint receptacle 241, and an inwardly facing ledge 242 at the bottomsurface of inner cavity 240. In embodiments, spinal rod connectingmember 230 may also include an aperture 244 for reception of a screw(not shown) to facilitate retaining of an insert 290 (FIGS. 10A-10B),which will be described further below.

Referring now to FIGS. 8A-8C, a locking screw 280 includes a threadedportion 282 and a concave cavity 284 that is provided below the threadedportion 282 and on an underside of locking screw 280. In embodiments,concave cavity 284 may be dimensioned to have a substantially perfectfit with an arcuate top portion of ball joint 226. Spinal rod lockingscrew 280 further includes a tool cavity 286 so that a clinician maymanually screw locking screw 280 with a suitable tool (not shown), forexample, but not limited to a screwdriver or a TORX® wrench.

Referring now to FIGS. 10A and 10B, an insert 290 is shown to include atop portion 292 and a bottom portion 294 that is dimensioned to have acurved bottom surface 295. Top portion 292 includes a concave cavity 296and a post 297 that is provided in the center of the cavity 296. Concavecavity 296 is configured to receive a bottom portion of ball joint 226during assembly. A saddle 298 is provided alongside a segment of topportion 292. Saddle 298 defines a space that is configured to receiveball connecting member 224 when ball joint 226 is sandwiched betweenscrew 280 and insert 290. Insert 290 further includes a radial groove299 that is annularly defined alongside a middle portion thereof. Inembodiments, radial groove 299 is configured to receive a screw (notshown) via aperture 244 such that the screw may retain insert 290 at acertain position in a compressive fashion.

During use and assembly of transverse connector 200 and referring backto FIG. 6F, insert 290 is positioned within inner cavity 240 of lockingscrew receptacle 234 such that curved bottom portion 295 abuts inwardlyfacing ledge 242 of inner cavity 240. Subsequently, ball joints 226 ofcross member 220 are positioned within their respective ball jointreceptacles 241, while inserts 290 are configured and adjustably turnedsuch that saddles 298 provide a securing seat for their respective ballconnecting members 224. In addition, post 297 of insert 290 loosely fitswithin recess 228 of ball joint 226 to provide predefined amount ofrotation of ball joint 226 within ball joint receptacle 241, while abottom portion 226 a of ball joint 226 is seated within concave cavity296 of insert 290.

Subsequently, locking screw 280 is placed and rotated (e.g., screwed)into the threaded portion 238 of locking screw receptacle 238, whileconcave cavity 284 on the underside of screw 280 exerts compressiveforces against the convex top portion of ball joint 226. At the sametime, bottom portion 226 a of ball joint 226 exerts compressive forcesagainst the top portion 292 of insert 290. That is, the bottom arcuateportion of ball joint 226 abuts the top arcuate cavity of insert 290. Asdiscussed above, recess 228 of ball joint 226 is configured to receivepost 297 of top portion 292, which thereby constricts the articulatingmovement of ball joint 226 to a limited amount of movement andadjustment. In this configuration, as threaded portion 282 of lockingscrew 280 is threaded further into threaded portion 238 of receptacle234, bottom portion 226 a of ball joint 226 exerts compressive forcesagainst the top portion 292 of insert 290, which in turn 295 on theunderside of insert 290 is brought into contact with the inwardlydirected annular restricting ledge 242 of inner cavity 240 of receptacle234 to create a tight fit.

It is envisioned that transverse connector 200 provides a low profilemeans for attaching to the rod, such that none of the transverseconnector compromises the anatomy (dura and spinal cord) that residesbetween the rods. It is also envisioned that this embodiment stillprovides the ball joint feature as means of attachment of the crossmember to the spinal rod attaching member, which allows for at least 3degrees of freedom for attachment. In addition, this embodiment stillallows for various lengths of cross member 220 to accommodate varioussized patients. Spinal rod connecting member 230 is biased laterallywith respect to cross member 220 so as to provide the maximum amount ofspace possible for critical anatomical structures (dura and spinalcord). As discussed above, cross member 220 may also be designed to havean adjustable length or can come in various predetermined lengths toaccommodate patient anatomy.

Referring now to FIGS. 11A-11D, another embodiment of a transverseconnector is shown and generally depicted as 300. Transverse connector300 is similar to other embodiments described herein and therefore isonly described herein to the extent necessary to describe thedifferences in construction and operation thereof. Transverse connector300 includes an adjustable cross member 310, spinal rod connectingmembers 230, and a cross member locking screw 280. In embodiments, crossmember 310 is offset from spinal rod connecting members 230 to providesufficient space for spinal anatomy and to therefore not impinge onsurrounding tissue or spinal elements. Transverse connector 300 includesspinal rod connecting member 230, similar to transverse connector 200,which defines a spinal rod passage 236 adapted to receive and contain aspinal rod 90 (as shown in FIG. 11B). Spinal rod connecting member 230of transverse connector 300 is substantially similar to the spinal rodconnecting member 230 used with transverse connector 200, thus furtherdescription thereof will be omitted in the interest of brevity.

Adjustable cross member 310 includes a receiving arm 312, an insertionarm 314, a cross member locking screw 316 and a cross member lockingscrew receptacle 317. During use, as cross member locking screw 316 istightened, cross member locking screw 316 is configured to exertpressure against insertion arm 314 to maintain insertion arm 314 at aspecific position. In this manner, adjustable cross member 310 may beadjusted to a desired length in accordance to a surgeon's specificationby loosening and tightening cross member locking screw 316. Adjustablecross member 310 is connected to spinal rod connecting member 230 in asimilar manner as arcing cross member 220 is connected to spinal rodconnecting member 230, as described above. For example, adjustable crossmember 310 includes a ball joint 320 on each arm 312 and 314,respectively, that is connected by a ball connecting member 318. Asshown in FIG. 11D, each ball joint 320 defines a recess 322 that isdisposed within a cross member locking screw receptacle 234. In thisconfiguration, recess 322 of ball joint 320 is configured to receive apost 297 of an insert 290 in a similar fashion as described above.Spinal rod connecting member 230 of transverse connector 300 issubstantially similar to the spinal rod connecting member 230 used withtransverse connector 200, described above, thus further descriptionthereof will be omitted in the interest of brevity.

Referring now to FIGS. 12A-12D, another embodiment of a transverseconnector is shown and generally depicted as 400. Transverse connector400 is similar to other embodiments described herein and therefore isonly described herein to the extent necessary to describe thedifferences in construction and operation thereof. Transverse connector400 includes a receiving arm assembly 410, an insertion arm assembly430, and a spinal rod connecting member 450. As can be appreciated, thereceiving arm assembly and the insertion arm assembly collectivelydefine a cross member, as discussed above with respect to some of theother embodiments.

Receiving arm assembly 410 includes a receiving arm 412 and a receivingarm extension 414 having an articulating ball joint 418 connected via aball connecting member 416. Ball joint 418 includes a top surface 418 athat defines a recess 418 b. Receiving arm assembly 410 further includesreceiving arm guides 420 a and 420 b that define an opening 422therebetween and configured to receive insertion arm assembly 430.

Insertion arm assembly 430 includes an insertion arm 432 and aninsertion arm extension 434 having an articulating ball joint 438connected via a ball connecting member 436. Similar to ball joint 418,ball joint 438 includes a top surface 438 b that defines a recess 438 a.Insertion arm 432 includes a screw receptacle 440 having threads 442disposed alongside an inner periphery therewithin for receiving aninsertion arm locking screw 490.

Referring to FIG. 12D, insertion arm locking screw 490 is shown havingthreads 492, a bottom surface 494, and a tool cavity 496 so that aclinician may manually screw locking screw 480 with a suitable tool (notshown).

Spinal rod connecting member 450 includes a top portion 452 and a bottomportion 454, which each define compression slots 456 a and 456 b,respectively (as shown in FIG. 12B). Spinal rod connecting member 450further includes a locking screw receptacle 458 that is configured toreceive a cross member connection locking screw 480, as will bedescribed further below. Each spinal rod connecting member 450 defines aspinal rod connecting passage 460 that is provided on a bottom portionof spinal rod connecting member 450. Spinal rod connecting passage 460is configured to receive and securely retain a spinal rod 90 (as shownin FIG. 12B).

Still referring to FIG. 12D, cross member connecting locking screw 480is shown having threads 482 alongside of locking screw 480. On a topportion, locking screw 480 includes a tool cavity 486 so that aclinician may manually screw locking screw 480 with a suitable tool (notshown), for example, but not limited to a screwdriver or a TORX® wrench.On a bottom portion, locking screw 480 includes a concave cavity 488 anda post 484 that is provided in the center of the concave cavity 488.Post 484 is configured to be inserted within recess 438 a of top surface438 b of ball joint 438 during assembly to provide a friction fit.

During use and assembly of transverse connector 400 and referring backto FIG. 6F, locking screw 480 is positioned within locking screwreceptacle 458 such that concave cavity 488 and post 484 is positionedwithin recess 438 a of top surface 438 b of ball joint 438 duringassembly to provide a friction fit.

Subsequently, as locking screw 480 is placed and rotated (e.g., screwed)into locking screw receptacle 458, concave cavity 488 and post 484 onthe underside of screw 480 exert compressive forces against and withinrecess 438 a of top surface 438 b of ball joint 438 during assembly toprovide a friction fit.

It is envisioned that transverse connector 400 provides a low profilemeans for attaching to the rod, such that none of the connectorcompromises the anatomy (dura and spinal cord) that resides between therods. It is also envisioned that this embodiment still provides the balljoint feature as means of attachment of the cross member to the spinalrod attaching member, which allows for at least 3 degrees of freedom forattachment. In addition, this embodiment still allows for variouslengths of receiving arm assembly 410 and insertion arm assembly 430 toaccommodate various sized patients. Spinal rod connecting member 450 isbiased laterally with respect to receiving arm assembly 410 andinsertion arm assembly 430 so as to provide the maximum amount of spacepossible for critical anatomical structures (dura and spinal cord).

Turning now to FIGS. 13A-13D, another embodiment of a transverseconnector is shown which is generally referred to as transverseconnector 500. Transverse connector 500 is similar to other embodimentsdescribed herein and therefore is only described herein to the extentnecessary to describe the differences in construction and operationthereof. Transverse connector 500 includes a pair of substantiallyidentical spinal rod connection members 550. One of the pair of spinalrod connection members 550 is secured to a receiving arm assembly 510and the other of the pair of the spinal rod connection members 550 issecured to an insertion arm assembly 530. The receiving arm assembly 510and the insertion arm assembly 530 are slidably disposed relative to oneanother between the pair of spinal rod connection members 550.

Referring again to FIG. 13A, each spinal rod connection member 550includes a body portion 552 and an extension portion 554. The body andextension portions 552, 554 define a cavity 555 therebetween that isconfigured to receive one of the insertion arm assembly 530 and thereceiving arm assembly 510. With brief reference to FIG. 13C, spinal rodconnection member 550 includes first compression slot 556 a and secondcompression slot 556 b. Spinal rod connection member 550 furtherincludes a locking screw receptacle 558 that is configured to receive across member connection locking screw 580, as will be described furtherbelow. A spinal rod connection passage 560 is defined through theextension portion 554 of the spinal rod connection member 550 and isconfigured to receive and securely retain a spinal rod 90 as shown inFIG. 1B.

As best depicted in FIG. 13D, receiving arm assembly 510 includes areceiving arm 512 and a receiving arm extension 514 having anarticulating ball joint 518 on a lateral end of the receiving armextension 514. The ball joint 518 is configured to be positioned withinthe cavity 555 defined between the body and extension portions 552, 554of one of the spinal rod connection members 550. Ball joint 518 includesa top surface 518 a that defines a ball joint recess 518 b.

Referring also to FIG. 13B, receiving arm assembly 510 further includesreceiving arm guides 510 a and 510 b that define an opening 522therebetween. The opening 522 is configured to receive insertion armassembly 530.

As shown in FIG. 13D, insertion arm assembly 530 includes an insertionarm 532 and an insertion arm extension 534. The insertion arm extension534 includes an articulating ball joint 538 on a lateral end of theinsertion arm extension 534. Similar to ball joint 518, ball joint 538includes a top surface 538 a that defines a ball joint recess 538 b.Insertion arm 532 includes a screw receptacle 540 having internalthreads 542 defined along an inner surface of the screw receptacle 540for receiving an insertion arm locking screw 590.

Continuing to refer to FIG. 13D, insertion arm locking screw 590 isshown having threads 592 and a tool cavity 596 so that a clinician maymanually screw locking screw 590 with a suitable tool (not shown) withinscrew receptacle 540 of insertion arm 532.

A pair of cross member connection locking screws 580 is also shown inFIG. 13D. Each locking screw 580 is shown positioned within one of thelocking screw receptacles 558 of one of the spinal rod connectionmembers 550. Each cross member connection locking screw 580 has threads582 defined along an external surface of the locking screw 580. On a topportion, locking screw 580 includes a tool cavity 586 so that aclinician may manually screw locking screw 580 with a suitable tool (notshown), for example, but not limited to a screwdriver or a Torx® wrench.On a bottom portion, locking screw 580 includes a concave cavity 588 anda post 584 that is provided in the center of the cavity 588. Post 584 isconfigured to be inserted within recess 538 b of ball joint 538 orrecess 518 b of ball joint 518 during assembly. In particular, toprovide a friction fit during assembly, as locking screw 580 is placedand rotated (e.g., screwed) into locking screw receptacle 558, concavecavity 588 and post 584 on the underside of screw 580 exerts compressiveforces against ball joint 538 or ball joint 518. The compressive forcesmay be exerted against top surface 538 a or top surface 518 a. As can beappreciated, when locking screw 580 is fully seated within recess 518 bor recess 538 b, one or both of the spinal rod connecting members 550may maintain a limited range of motion with respect to ball joint 518 orball joint 538 by virtue of a space 599, which may be annular, definedbetween the post 584 of locking screw 580 and one of the top surfaces518 a or 538 a of recess 518 b, 538 b.

Referring now to FIGS. 14A and 14B, another embodiment of a transverseconnector is shown which is generally referred to as transverseconnector 600. Transverse connector 600 is similar to other embodimentsdescribed herein and therefore is only described herein to the extentnecessary to describe the differences in construction and operationthereof. Transverse connector 600 includes an arm assembly 610 disposedbetween a pair of substantially identical spinal rod connection members550.

Illustrated best in FIG. 14B, arm assembly 610 includes a cross member612 having a pair of arm extensions 614 extending from the cross member612 on opposed lateral ends of the cross member 612. Each arm extension614 tapers to a ball joint 618 on the lateral end of the arm extension614. Like, ball joint 518, ball joint 618 is configured to be positionedwithin the cavity 555 defined between the body and extension portions552, 554 of one of the spinal rod connection members 550. Ball joint 618includes a top surface 618 a that defines a ball joint recess 618 b. Ascan be appreciated, one or more locking screws 580 may be used inconnection with transverse connector 600 substantially similarly asdescribed above with regard to transverse connector 500.

Turning to FIGS. 15A and 15B, yet another embodiment of a transverseconnector is shown which is generally referred to as transverseconnector 700. Transverse connector 700 is similar to other embodimentsdescribed herein and therefore is only described herein to the extentnecessary to describe the differences in construction and operationthereof. Transverse connector 700 includes a pair of substantiallyidentical spinal rod connection members 450, a receiving arm assembly510, and an insertion arm assembly 530. One of the pair of spinal rodconnection members 450 is secured to the receiving arm assembly 510 vialocking screw 480 and the other of the pair of the spinal rod connectionmembers 450 is secured to the insertion arm assembly 530 via anotherlocking screw 480. The receiving arm assembly 510 and the insertion armassembly 530 are slidably disposed relative to one another between thepair of spinal rod connection members 450. The receiving arm assembly510 and the insertion arm assembly 530 may be fixed relative to oneanother via arm locking screw 590.

As can be appreciated, any of the embodiments of the presently disclosedtransverse connector can be used in connection with the bonescrew/spinal rod construct illustrated in FIG. 16 and discussed above.

Any of the embodiments of the presently disclosed transverse connectorcan be manufactured as components by methods known in the art, toinclude, for example, molding, casting, forming or extruding, andmachining processes. The components can be manufactured using materialshaving sufficient strength, resiliency and biocompatibility as is wellknown in the art for such connectors. By way of example only, suitablematerials can include implant grade metallic materials, such astitanium, cobalt chromium alloys, stainless steel, or other suitablematerials for this purpose. It is also conceivable that some componentsof the connector can be made from plastics, composite materials, and thelike.

It is also within the concept of the inventors to provide a kit, whichincludes at least one of the embodiments of the presently disclosedtransverse connector. The kit can also include additional orthopedicdevices and instruments; such as for example, instruments for tighteningor loosening the locking screws, spinal rods, hooks or links and anyadditional instruments or tools associated therewith. Such a kit can beprovided with sterile packaging to facilitate opening and immediate usein an operating room.

Each of the embodiments described above are provided for illustrativepurposes only and it is within the concept of the present disclosure toinclude modifications and varying configurations without departing fromthe scope of the disclosure that is limited only by the claims includedherewith.

The invention claimed is:
 1. A transverse connector comprising: a crossmember having first and second ball joints connected thereto; first andsecond spinal rod connecting members supported on the first and secondball joints of the cross member, respectively, each of the first andsecond spinal rod connecting members defining a spinal rod connectingpassage therethrough and a locking screw receptacle therein; and alocking screw having a post extending longitudinally therefromconfigured to be received within a recess defined within the first balljoint and the post extends from a recess defined within an underside ofthe locking screw, the recess configured to receive at least a portionof the first ball joint therein, the locking screw received within thelocking screw receptacle of the first spinal rod connecting member androtatable in a first direction to engage with the first ball joint andfix the first spinal rod connecting member relative to the cross member,the locking screw being rotatable in a second direction to enable thefirst spinal rod connecting member to move about the first ball jointrelative to the cross member, the locking screw sharing a common axiswith the first ball joint.
 2. The transverse connector of claim 1,wherein the locking screw is threadedly engagable with the locking screwreceptacle of the first spinal rod connecting member.
 3. The transverseconnector of claim 1, wherein a recess of the locking screw defines aconcave cavity configured to receive and abut a portion of the firstball joint.
 4. The transverse connector of claim 1, wherein each of thespinal rod connecting members are coupled to the respective first andsecond ball joints at body portions thereof, and the spinal rod passagesextend through corresponding extension portions thereof.
 5. Thetransverse connector of claim 4, wherein each of the spinal rodconnecting members further defines a first compression slot through thebody portion and a second compression slot through the extensionportion.
 6. The transverse connector of claim 5, wherein the firstcompression slot extends into the locking screw receptacle of the spinalrod connecting member.
 7. The transverse connector of claim 5, whereinthe second compression slot extends into a cavity defined by the spinalrod connecting member, the cavity configured to receive one of thecorresponding first or second ball joints therein.
 8. A transverseconnector comprising: first and second ball joints, the first ball jointdefining a recess; a cross member connecting the first and second balljoints; first and second spinal rod connecting members, each spinal rodconnecting member defining a spinal rod passage therethrough and alocking screw receptacle therein, wherein the first and second balljoints support the first and second spinal rod connecting members,respectively; and a locking screw having a post configured to connectthe first ball joint and the locking screw, the post configured to bereceived within the recess defined within the first ball joint andextending from a recess defined on an underside of the locking screw,wherein the recess configured to receive at least a portion of the firstball joint therein, the locking screw rotatable in a first direction toengage the first ball joint and be received within the locking screwreceptacle of the first spinal rod connecting member thereby fixing thefirst spinal rod connecting member relative to the cross member, thelocking screw rotatable in a second direction to enable the first spinalrod connecting member to move about the first ball joint relative to thecross member, the locking screw sharing a common axis with the firstball joint.
 9. The transverse connector of claim 8, wherein the lockingscrew is threadedly engagable with the locking screw receptacle of thefirst spinal rod connecting member.
 10. The transverse connector ofclaim 8, wherein the recess of the locking screw defines a concavecavity configured to receive and abut a portion of the first ball joint.11. The transverse connector of 8, wherein the first and second spinalrod connecting members are coupled to the respective first and secondball joints at body portions thereof, and the spinal rod passages extendthrough corresponding extension portions thereof.
 12. The transverseconnector of claim 11, wherein each spinal rod connecting member furtherdefines a first compression slot through the body portion and a secondcompression slot through the extension portion.
 13. The transverseconnector of claim 12, wherein the first compression slot extends intothe locking screw receptacle.
 14. The transverse connector of claim 12,wherein the second compression slots extends into a cavity defined bythe spinal rod connecting member, the cavity configured to receive oneof the first or second ball joints therein.